Tirzepatide and Bariatric Surgery

[fyrepep]

Have any of y'all had bariatric surgery, had regain, and followed it up with some tirzepatide?

Typically, post bariatric patients are excluded from the studies, but it sounds like there has been success with tirzepatide usage post-bariatric. But the data is so limited...

 

[firefly96]

I had a VSG in 2013. Lost 154 lbs. Regained about 40 lbs over the last few years. About to take my 4th dose of Tirz and it’s working well for me so far. I have about 40 lbs to lose to get down to my absolute most amazing GW.

 

[clevesand]

I had VSG in 2010 and kept almost all the weight off for 9 years. I slowly gained 40 pounds the last 5 years and it dropped off very quickly with T. I am now only 4 pounds heavier than my lowest following surgery. I will say that T has completely "reset" my stomach. It feels like the early days post-surgery with food restriction. My only advice for you is to work really hard with caloric intact the first 4 months because, at least for me, the efficacy of T in decreasing appetite decreased substantially after 5 months regardless of how I titrated up on the dose.

 

[Nikki nik]

I had VSG in 2010 and kept almost all the weight off for 9 years. I slowly gained 40 pounds the last 5 years and it dropped off very quickly with T. I am now only 4 pounds heavier than my lowest following surgery. I will say that T has completely "reset" my stomach. It feels like the early days post-surgery with food restriction. My only advice for you is to work really hard with caloric intact the first 4 months because, at least for me, the efficacy of T in decreasing appetite decreased substantially after 5 months regardless of how I titrated up on the dose.

Thanks! I see some switching glps because of no longer being effective after months on tirz

 

[Dustycotton]

I had an RNY May 2000. Lost 140 lbs and stayed within the same 10lbs for about 8 years and then slowly started regaining. Eventually got back to, and surpassed starting weight by 30 lbs. I started tirz Dec 2023 and am now just over halfway to my 160 lb goal again. Total lost since starting is 67 lbs. I'm at 12.5mg split dose per week, and have been for 10 weeks. Just this past week I added 0.3mg cagrilintide.

 

[Dee X]

For those who had the surgery, what do you think of the effects of surgery vs the shots with your appetite? Which do you feel was better for you?

 

[nurseratchit]

I have not had any bariatric surgery but I know a lot of people using glp1s who have and are doing well, if not better since starting them. If you go off the meds you can probably expect to regain but many people back down to lower doses once they reach their maintenance zone.

 

[DilithiumDonut]

Up front I'll tell you, I know now that my main obesity and diabetes problem is food noise. Tirz revealed that to me when I woke up on Nov 7 2023, after having taken the first shot the night before, and my food noise was gone. I had gotten control of my life back.

I had gastric bypass in 2017. At almost 300 lbs (M, 5' 6"), my surgeon made me go on ultra low carb diet to lose as much as possible before the surgery. It was 8 months of Hell thanks to the food noise. Absolutely brutal and I know there was some clinical depression in there (maybe PTSD lol???) along the way due to it. Got down to 220 and had the surgery, which got me to about 180. Then I started slowly gaining over the years. Last year was back to 240 when I started Mounjaro after I got a new diabetes Dr and he put me on it.

On Nov 8 2023 I completely changed my eating habits for the better, and have had a fairly consistent 2lb/week loss. I'm at maintenance now, bouncing around 150-153.

There have been a few dosage modifications along the way. I'm currently on 5mg every 4 days.

Tirz gave me my life back and got me where I wanted to be with my weight. Surgery couldn't do that because surgery can't touch the food noise.

I plan to be on tirz or something like it for life.

 

[clevesand]

For those who had the surgery, what do you think of the effects of surgery vs the shots with your appetite? Which do you feel was better for you?

Surgery doesn't really do anything for appetite, which is why most people "eat their way around a sleeve" and gain weight eventually. You are physically restricted from eating a lot of food. They say your stomach produces less Ghrelin so you're not as hungry, but I'm not sure if that's real or voodoo science.

I was always able to use the surgery as a great tool and I just didn't keep garbage food in the house. When I started T, I was still only a 31.5 bmi, so I have done well in the last 14 years since surgery. But VSG and Tirz are a one-two punch. You are physically restricted, and you're not hungry anymore. If these meds had been around I would not have had the surgery. So much of life revolves around food. I find myself coming up with excuses to decline lunch and dinner invites because it creates a lot of anxiety and embarrassment for me hoping to not have to explain to people why I cannot hardly eat any food. I would love to be able to really enjoy a nice persian or Italian restaurant again--my favorites.

If anyone is interested, I highly recommend the surgeon in Mexico, Dr Alvarez.